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General NPI Number Information
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NPI Number | 1982031803
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Entity Type | Individual
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Provider Name | NATHAN SHAPPLEY PA-C
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Gender | Male
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Dates
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Enumeration Date | 10/09/2013
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Last Update Date | 11/09/2015
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Provider Practice Location Address
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Address Line | 1514 JEFFERSON HWY
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City | NEW ORLEANS
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State | LA
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Zip | 70121-2429
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Country | US
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Telephone | 504-842-3460
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Fax | 504-837-9271
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Provider Business Mailing Address
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Address Line | 2350 SCHILLINGER RD S
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City | MOBILE
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State | AL
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Zip | 36695-4177
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Country | US
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Telephone | 251-445-7614
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Fax | 251-410-6127
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 200809
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License Number State | LA
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Taxonomy #2
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 916
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License Number State | AL
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